Syringomas (Synonym: Hidradenoma)
Syringomas (Synonym: Hidradenoma) are benign proliferation of sweat gland ducts which may
occur in multiples. The clinical pictures shows raised skin-colored nodules, especially on the lower eye-lid. The typically cause no discomfort but may be cosmetically disturbing. This lesion is completely benign.
The following laser techniques are being applied for treatment; also alternative methods are described:
- Removal with the Erbium:YAG-laser or a apulsed or scanner triggered CO2-laser. In using this techniuqe, syringomas are vaporized and hus the skin becomes smooth. Small erosions, oozing for a few days and crust formation are typical immediate side-effects (as in any traumatic abrasion)
- Coagulation of syringomas with coagulation lasers (for example:l argon-laser/neodyme:YAG-laser). Syringomas are heated/coagulated and subsequently new tissue is formed. Crust formation and minimal scarring may occur.
- Alternatively, injecting the area with Botolinumtoxin A (Botox) is possible. No laser is employed in this procedure. Through an inhibition of the receptors of the sweat glands, sweat production s stopped. Treatment typically has to be repeated after 4-8 months. Side-effects may involve formation of small hematomas at the injection site.
- Flat syringomas may also be treated by topical peelings that lead to cauterization of the ducts and may yield very good clinical results; however more prominent syringomas cannot be treated with this method.
- Also, the so-called shave excision, using a sterile needle and lifting the syringoma before shaving it off with a scalpell, can be employed. In doing so, the shaved material can be examined histologically.
The problem of all therapies is the depth of syringomas. They often reach far in to the dermis thus often resulting in the following:
- The syringoma is removed at surface skin level; as a rest remains in the deeper layers, the syringoma may recur.
- The syringoma is excised/cauterized completely, including its deep parts in the skin; recurrence can be avoided but small scars may result.
Thus, in case of doubt, one would rather remove the syringoma more superficially in order to prevent a cosmetically disturbing scar. Typically, we perform a trial treatment before treating large areas.
In general, the above listed methods lead to a cosmetically pleasing result.
